Hypothyroidism (Underactive Thyroid) Part 1: Too Little Thyroid

Hormone
Hypothyroidism is a condition in which the body lacks sufficient thyroidhormone. Since
the main purpose of thyroid hormone is to "run the body's metabolism," it is
understandable that people with this condition will have symptoms associated with a
slow metabolism. The estimates vary, but approximately 10 million Americans have this
common medical condition. In fact, as many as 10% of women may have some degree
of thyroid hormone deficiency. Hypothyroidism is more common than you would
believe, and millions of people are currently hypothyroid and don't know it. For an
overview of how thyroid hormone is produced and how its production is regulated,
check out our thyroid hormone production page.
Causes of Hypothyroidism
There are two fairly common causes of hypothyroidism. The first is a result of previous
(or currently ongoing) inflammation of the thyroid gland, which leaves a large
percentage of the cells of the thyroid damaged (or dead) and incapable of producing
sufficient hormone. The most common cause of thyroid gland failure is
called autoimmune thyroiditis (also called Hashimoto's thyroiditis), a form of thyroid
inflammation caused by the patient's own immune system.
The second major cause is the broad category of "medical treatments." The treatment of many
thyroid conditions warrants surgical removal of a portion or all of the thyroid gland. If the total
mass of thyroid producing cells left within the body are not enough to meet the needs of the
body, the patient will develop hypothyroidism. Remember, this is often the goal of the surgery
for thyroid cancer.
But at other times, the surgery will be to remove a worrisome nodule, leaving half of the thyroid
in the neck undisturbed. Sometimes, this remaining thyroid lobe and isthmus will produce
enough hormone to meet the demands of the body. For other patients, however, it may become
apparent years later that the remaining thyroid just can't quite keep up with demand.
Similarly, goiters and some other thyroid conditions can be treated with radioactive iodine
therapy. The aim of the radioactive iodine therapy (for benign conditions) is to kill a portion of
the thyroid to prevent goiters from growing larger or producing too much hormone
(hyperthyroidism).
Occasionally, the result of radioactive iodine treatment will be that too many cells are damaged
so the patient often becomes hypothyroid within a year or two. However, this is usually greatly
preferred over the original problem.

There are several other rare causes of hypothyroidism, one of them being a completely
"normal" thyroid gland that is not making enough hormone because of a problem in
the pituitary gland. If the pituitary does not produce enough thyroid stimulating hormone
(TSH) then the thyroid simply does not have the "signal" to make hormone. So it
doesn't.
Symptoms of Hypothyroidism
 Fatigue
 Weakness
 Weight gain or increased difficulty losing weight
 Coarse, dry hair
 Dry, rough pale skin
 Hair loss
 Cold intolerance (you can't tolerate cold temperatures like those around you)
 Muscle cramps and frequent muscle aches
 Constipation
 Depression
 Irritability
 Memory loss
 Abnormal menstrual cycles
 Decreased libido
 Each individual patient may have any number of these symptoms, and they will
vary with the severity of the thyroid hormone deficiency and the length of time the
body has been deprived of the proper amount of hormone.

 You may have one of these symptoms as your main complaint, while another will
not have that problem at all and will be suffering from an entirely different
symptom. Most people will have a combination of these symptoms. Occasionally,
some patients with hypothyroidism have no symptoms at all, or they are just so
subtle that they go unnoticed

If you have these symptoms, you need to discuss them with your doctor. Additionally,
you may need to seek the skills of an endocrinologist. If you have already been
diagnosed and treated for hypothyroidism and continue to have any or all of these
symptoms, you need to discuss it with your physician.

Potential Dangers of Hypothyroidism

Because the body is expecting a certain amount of thyroid hormone the pituitary will
make additional thyroid stimulating hormone (TSH) in an attempt to entice the thyroid to
produce more hormone. This constant bombardment with high levels of TSH may cause
the thyroid gland to become enlarged and form a goiter (termed a "compensatory
goiter").

Left untreated, the symptoms of hypothyroidism will usually progress. Rarely,

complications can result in severe life-threatening depression, heart failure, or coma.

Hypothyroidism can often be diagnosed with a simple blood test. In some persons,
however, it's not so simple and more detailed tests are needed. Most importantly, a
good relationship with a good endocrinologist will almost surely be needed.
Hypothyroidism is completely treatable in
many patients simply by taking a small pill
once a day. However, this is a

Hyperthyroidism:
sim

Symptoms & Signs

plified statement, and it's not always so easy. There are several types of thyroid hormone
preparations and one type of medicine will not be the best therapy for all patients. Many factors
will go into the treatment of hypothyroidismand it is different for everybody.

Symptoms of hyperthyroidism arise from the elevated levels of thyroid hormones

produced by the overactive thyroid gland. Excessive intake of thyroid hormones can
produce these symptoms as well. Characteristic symptoms include a rapid heart
rate, excessive sweating, intolerance to heat, tremor, nervousness, or agitation. Other
symptoms can include fatigue, weight loss, hair loss, increased appetite, problems with
concentration, frequent bowel movements, and irregular or decreased menstrual blood
flow in women. Sometimes, thyroid nodules or an enlarged thyroid gland (goiter) are
apparent. With severe hyperthyroidism, cardiac arrhythmias, fever, high blood pressure,
and heart failure can develop.

Causes of hyperthyroidism

There are many causes of hyperthyroidism. Graves' disease is a generalized overactivity

of the thyroid gland and the most common cause of hyperthyroidism. Other causes
include thyroid growths or tumors that produce thyroid hormone such as functioning
adenoma and toxic multinodular goiter (TMNG). Excessive intake of thyroid hormones
or excessive iodine intake can cause the condition. Other causes can include abnormal
secretion of TSH and thyroiditis (inflammation of the thyroid gland).
REFERENCE:

Lee, Stephanie L. "Hyperthyroidism." Medscape. Mar. 17, 2017.

<http://emedicine.medscape.com/article/121865-overview>.

Medically Reviewed by a Doctor on 4/26/2017

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Symptoms and Signs

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Hyperthyroidism
Symptoms and Signs
 Agitation
 Arrhythmias (Abnormal Heartbeat)
 Clammy Skin
 Difficulty Concentrating
 Fatigue
 Fever
 Frequent Bowel Movements
 Goiter
 Hair Loss
 Heart Failure
 Heat Intolerance
 High Blood Pressure
 Hyperactivity
 Increased Appetite
 Increased Sweating
 Irregular Menstrual Periods
 Itching
 Nausea
 Nervousness
 Palpitations
 Sleep Disturbances
 Swelling Around the Eyes (Apparent Protrusion of the Eyes)
 Thyroid Nodule
 Tremor
 Vomiting
 Warm Skin
 Weakness
 Weight Loss
 Examples of
Medications for
Hyperthyroidism
Symptoms and Signs
 atenolol, Tenormin
 methimazole, Tapazole
 metoprolol (Lopressor, Toprol XL)
 propranolol, Inderal, Inderal LA, Innopran XL
 propylthiouracil

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